The Department of Health and Human Services and Drug Enforcement Administration Dec. 30 released a temporary rule extending for the fourth time waiver flexibilities for prescribing controlled substances via telemedicine. The waivers allow for the prescribing of schedule II-V controlled substances (including schedule III-V medications approved by the Food and Drug Administration for treatment of opioid use disorder) via audio-video telemedicine encounter without a prior in-person medical evaluation through Dec. 31, 2026. These flexibilities apply to all practitioner-patient relationships, not just those established during the COVID-19 public health emergency. The waivers were due to expire on Dec. 31, 2025; by extending them for another year, the agencies have additional time to develop and implement a permanent special registration process for prescribing of controlled substances.